Spots on Tongue

Tongue spots range from bumps that are just part of a healthy tongue to lesions that mean you have a health condition. In most cases, these spots are harmless. But certain spots on your tongue can signal health issues, like a food allergy, autoimmune disease or infection. Less commonly, the spots can mean tongue cancer.

If you’re unsure about what’s causing spots on your tongue and they aren’t going away, see your dentist or primary care physician for help.

What kinds of spots are present on a healthy tongue?

Your tongue is covered with papillae — tiny bumps and projections that help with sensory things like speaking, chewing food and detecting temperature. Some contain taste buds. There are four kinds of papillae:

• Circumvallate: These are the largest type. Found on the very back of your tongue, they contain about 250 taste buds.
• Filiform: These are at the front and in the center of your tongue. They appear threadlike and don’t contain taste buds. You have more of this type of papillae than any other.
• Foliate: These papillae look like rough folds of tissue and are on each side of the back of your tongue. You have about 20 foliate papillae. Each contains several hundred taste buds.
• Fungiform: Most people have 200 to 400 fungiform papillae. They’re all over your tongue, but they’re most prominent at the edges and tip. Each contains about three to five taste buds.

You don’t need to worry about these “spots.”

What are the most common conditions that may involve spots on my tongue?

Most tongue spots aren’t dangerous, and they usually get better without treatment. But with some, you may need medicine or a procedure to get rid of them. Here are some of the most common spots you can get on your tongue and what they look like:

Canker sores

Canker sores are small ulcers that develop in the lining of your mouth. They look white or yellowish and usually have a red border. Canker sores can appear on your tongue, lips, inner cheeks or even the roof of your mouth. Healthcare providers don’t know what causes them. But minor injuries to the inside of your mouth and stress are possible triggers.

Most canker sores go away on their own within a few weeks. In the meantime, there are medicines and mouthwashes that can help ease the symptoms.

Cold sores

Also called fever blisters, cold sores look like fluid-filled blisters. Sometimes, they appear in clusters. They often appear on your lips, but you can also get them on your tongue. The herpes simplex virus (HSV-1) causes cold sores. HSV-1 easily spreads through saliva or close contact.

There are over-the-counter and prescription options for treating cold sores. Your healthcare provider can help you find a product that works for you.

Geographic tongue

Geographic tongue gets its name because of its “map-like” appearance. People with the condition develop smooth patches of redness or discoloration on their tongues. These areas are often surrounded by a white or light-colored border.

Geographic tongue is totally harmless, and it’s not contagious. Treatment usually isn’t necessary unless it’s causing symptoms.

Lie bumps (transient lingual papillitis)

Lie bumps are very common. They happen when the papillae on your tongue enlarge or become inflamed. They usually appear as small red or white bumps. They get their name from a myth that a person could develop them after telling a lie. In reality, they happen when you injure your tongue or something irritates it.

They usually go away on their own within a few days. They’re not dangerous and typically don’t require treatment.

Oral thrush

Oral thrush is a fungal infection. It’s not highly contagious, but it can spread to people with weakened immune systems. People with thrush develop raised, white spots on their tongues and inner cheeks. These irritated areas may look like cottage cheese.

You can scrape these lesions off, but doing so will cause bleeding. Your healthcare provider can prescribe an antifungal medicine to clear up the infection.

Lichen planus

Oral lichen planus is a condition that irritates the skin lining your mouth. It occurs when your immune system attacks cells in your body for unknown reasons. Oral lichen planus can look like white, lacy patches. It can also result in open sores or swollen tissues.

Your healthcare provider can prescribe medications to help manage symptoms.

Leukoplakia

Leukoplakia lesions look like white or gray patches or spots inside your mouth. These spots can develop on or under your tongue or on your inner cheeks. You can’t scrape or rub them off.

Experts don’t know what causes them, but using tobacco products and drinking too much alcohol may increase your risk. Related, people who develop leukoplakia have an increased risk of oral cancer. But most people who get leukoplakia don’t go on to develop oral cancer.

In most cases, healthcare providers recommend removing leukoplakia lesions with surgery.

Erythroplakia

Erythroplakia causes red spots to develop inside your mouth. You can get these lesions on your tongue or the floor of your mouth. Like leukoplakia lesions, areas of erythroplakia don’t come off when scraped.

It’s also linked to tobacco and alcohol, and it may increase your oral cancer risk.

Healthcare providers treat erythroplakia with radiation, surgery or by eliminating relevant risk factors.

Tongue cancer

Tongue cancer is a head and neck cancer that starts in the cells that line your tongue. Cancerous lesions may look like red or white patches. Sometimes, they’re open sores that won’t go away.

The treatment you’ll need depends on the cancer stage, your overall health and your preferences.

When should this symptom be treated by a doctor or healthcare provider?

You should call a healthcare provider any time you notice a new sore spot or ulcer on your tongue or in your mouth — especially if it doesn’t go away within two weeks.

Schedule an appointment if the spot seems to be growing or happens alongside other symptoms, like:

• Bleeding from the lesion
• Changes in your sense of taste
• Mouth pain
• Trouble eating or drinking